Understanding Value-Based Payment Models Can Enhance Patient Care, Lower Costs

Over the last few decades, the healthcare industry has experienced a significant shift from fee-for-service (FFS) payments to value-based payments (VBP). Value-based care delivery models, which base payment on outcomes versus the number of services provided, are key when it comes to improving patient care and lowering costs.

There are several forces driving the advancement of value-based models, including:

  • Significant government program influence.
  • Investor interest in value-based strategy.
  • Consumer expectations for access to more personalized, high-quality care.

The VBP movement, while flashy and exciting, can also be challenging for providers when it comes down to the details. The reasons for this include:

  • The necessary data sets can be disparate, slow, and incomplete.
  • The transparency between payers and risk-taking providers is often limited.
  • Private value-based contracts are often insufficiently detailed on important matters such as pricing trend and margin assumptions, the definition of revenue components to which percentage of premium contracts are applied, etc.

Given the market forces outlined above, it’s very likely providers will soon find themselves entering shared savings and/or risk contracts. It’s critical these providers work with actuaries who are skilled at disentangling complex value-based payment models and managing financial risk so that they can focus on what they do best: caring for patients. Wakely Consulting, an MHA Endorsed Business Partner (EBP), can assist hospitals and health systems with the task of translating complex VBP contracts to enhance patient care and lower costs.

Those interested in learning more are encouraged to visit the MHA EBP webpage or contact Rob Wood at the MHA.

Recording Available of Event Outlining Collection of SOGI Data Best Practices

MHA members were among those who virtually attended the webinar Collection of Sexual Orientation Gender Identity (SOGI) Data Best Practices for the Acute Care Setting. The event was hosted Nov. 10 by the Michigan Public Health Institute, the Michigan State University Institute for Health Policy, the MHA Keystone Center and Fenway Health. This training featured Chris Grasso, vice president, health informatics and data services, and Alex Keuroghlian, MD, director of the division of education and training at Fenway Health, who discussed best practices for collecting and documenting patient SOGI data in electronic health records. 

A recording of the webinar is available on the MHA Community site. Members with questions may contact the MHA Keystone Center.

Expansion of Skilled Nursing Services for Aging Population Explored in Webinar

Hospitals and health systems are experiencing a decrease in routine inpatient admissions, prompting development of other services. One of these services is post-acute care, which is expected to grow as the population ages and skilled nursing facilities (SNFs) are expanded and created. To build skilled nursing growth, providers use data focused on referral patterns to develop specialized programs based on patient needs, then promote those specialized services.

The MHA webinar Using Data to Grow Skilled Nursing Facility Admissions will explain each step of this strategic process, including real-world success stories demonstrating the value of this approach.

The webinar is scheduled from 10 to 11 a.m. Nov. 18, and MHA members can register for a $195 connection fee. Members with questions should contact Erica Leyko at the MHA.

Best Practices Reviewed for Collecting Patient Sexual Orientation, Gender Identity Data

MHA members are invited to participate in the webinar Collection of SOGI Data Best Practices for the Acute Care Setting, which will be held 9:30 to 11:30 a.m. ET Nov. 10. In this training, Chris Grasso, vice president, health informatics and data services, and Alex Keuroghlian, MD, director of the division of education and training, Fenway Health, Boston, discuss best practices for collecting patient sexual orientation and gender identity (SOGI) data and documenting SOGI in electronic health records. Registration is free for all Michigan hospitals.

As a result of the webinar, participants will be able to:

  • Summarize how to incorporate SOGI data collection into their workflow, using their electronic health records and quality improvement techniques to improve communication, quality care, and data and quality management activities.
  • Identify at least one method to actively engage and educate staff on the importance of collecting and using SOGI data, how to do so, the data’s impact on health disparities, and how SOGI can be used to direct education and clinical practice.
  • Identify at least one training, tool or another resource to assist their organizations in collecting and using SOGI data.

Members with questions may contact the MHA Keystone Center.